Download The Female Athlete Triad - National Athletic Trainers

The Female Athlete Triad
Taken from:
Managing the Female Athlete Triad. NCAA Coaches Handbook
National Athletic Trainers’ Associated Position Statement: Preventing
Detecting, and managing Disordered Eating in Athletes. Journal of
Athletic Training;
2008. 43(1):80-108
Female Athlete Triad
• Disordered Eating
• Includes the full spectrum of abnormal eating
behaviors, ranging from simple dieting to clinical
eating disorders.
• Amenorrhea
• The loss of menstruation
• Primary-the individual has not experienced her first
menstrual period by age 15 when secondary sex
characteristics have developed
• Secondary-the postmenarchal athlete misses three
consecutive periods.
• Osteoporosis
• Disease characterized by low bone mass and
deterioration of bones tissue, resulting in bone fragility
and increased risk of fracture.
Disordered Eating
• The term “disordered eating” is used rather
than eating disorders because the athlete's
eating does not have to be disordered to the
point of a clinical eating disorder in order for
the other two components of the athlete triad
to occur.
• Disordered Eating can be inadvertent such as
mistakenly eating too little to fuel the body.
• Willfully restricting caloric intake (dieting,
dietary restriction) is the primary precursor to
eating disorders.
Coaches Role in Recognizing
Disordered Eating
• Coaches are in a good position to identify
disordered eating.
• Identification can by complicated by sport body
stereotypes.
• Lean body types=increased performance &
good performance=good health.
• Coaches need to be aware of physical/medical
and psychological/behavioral signs and
symptoms of disordered eating.
Signs and Symptoms of Disordered Eating
Physical/Medical Signs and
Symptoms
Psychological/Behavioral
Signs and Symptoms
Amenorrhea
Dehydration
Gastrointestinal Problems
Hypothermia
Stress Fractures (overuse
injuries)
• Significant Weight Loss
• Muscle Cramps,
Weakness, or Fatigue
• Dental and Gum
Problems
• Anxiety and/or Depression
• Claims of “Feeling Fat”
Despite Being Thin
• Excessive Exercise
• Excessive Use of Restroom
• Unfocused, Difficultly
Concentrating
• Preoccupation with Weight
and Eating
• Avoidance of Eating and
Eating Situations
• Use of Laxatives, Diet Pills,
etc.
•
•
•
•
•
Amenorrhea
• Amenorrhea is very
common among female
athletes.
• Some female athletes even
see it as the “norm” for
sports among their peers;
this makes it very difficult to
catch because of lack of
reporting.
• It does not have to fall on
the coach to monitor for this
condition, rather, it should
fall into the hand of a team
physician, nurse, or athletic
trainer.
What to do?
• A designated health-care
professional should meet
with the team prior to each
season to inform the
student-athletes about the
importance of healthy
menstrual function.
• Make it clear how and to
whom they should report
any irregularities.
Amenorrhea
• Amenorrhea related to sport
participation can often be reversed.
• Common treatments include:
•
•
•
•
Increased caloric intake
Decrease in physical activity
Rare cases could require hormone therapy
An athlete’s response to recommendations
regarding eating, training, and medication
will vary. Difficulty in compliance usually
increases with the severity of the disordered
eating.
Osteoporosis
• Unfortunately, bone problems are
typically the first signs reported within the
triad.
• If frequent fractures, especially stress
fractures, are present, the student-athlete
should also be assessed for menstrual
dysfunction and disordered eating.
• The treatment of osteoporosis and
amenorrhea is key because it involves
the athlete's current and future
reproductive and bone health.
Prevention Strategies
1. De-emphasize weight
•
•
Emphasis on weight or thinness/leanness will likely increase the risk
of disordered eating.
De-emphasis will likely have the converse effect.
2. Recognize individual differences in
athletes
•
By focusing on the athlete's individual differences, the likelihood
of enhanced performance for each athlete can be increased
3. Education
•
•
Education should be made available to everyone involved
Coaches remain instrumental in the detection of the triad, therefore
education is key.
4. Involvement by Sport Governing Bodies